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But the pain of childhood abuse never goes away. It is linked to everything from anxiety to alcoholism. Researchers are becomingly increasingly convinced it also plays a role in adult obesity.

The latest piece of evidence comes from the University of Toronto. Researchers at the schools of social work and public health found that women who experienced physical abuse in childhood had an abnormally high rate of obesity. Their study, Carrying the Pain of Abuse, appears in the current edition of Obesity Facts, a European academic journal.

Social work professor Esme Fuller-Thomson and two doctoral candidates, Deborah Sinclair and Sarah Brennenstuhl, examined a 2005 health survey of 13,640 adults in Manitoba and Saskatchewan. Participants were asked about their height, weight, age, race, marital status, education, income level, dietary habits and health behaviour. There was one additional question: “Were you ever physically abused by someone close to you?”

The researchers expected to find a relationship between obesity and child abuse. Previous studies had shown a statistical correlation. But they were convinced it could be explained by other factors; poverty, race, age, substance abuse, depression or divorce, all of which are known to affect body weight.

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They were wrong. Even when they adjusted for all these variables, women from abusive families had a 35-per-cent greater probability of obesity.

There was a second surprise. They found no significant relationship between childhood abuse and adult obesity in men.

The health records the researchers used were too imprecise to draw firm conclusions about why so many abused girls grew into obese women and so many boys escaped that fate. The data did not differentiate, for example, between an occasional slap and regular violent beatings. There was a separate category for sexual molestation. “It is well accepted that the use of a single question is less valid than a series of questions,” Fuller-Thomson said.

She and her associates could only theorize using existing knowledge about the relationship between trauma and body image. It is possible, they suggested, that abused girls pack on weight to make themselves sexually unattractive to male aggressors. “Abused females learn that their body weight can be used to shield themselves from abuse.” It also is possible they seek out comfort food to ease their pain, they posited. As for boys, they might have different coping mechanisms: bullying, alcoholism, anger or withdrawal.

They did offer one definitive piece of insight: Public officials will not succeed in controlling or preventing obesity if they focus solely on diet and exercise, as most are doing now.

This study comes at a time when opinion on this issue is sharply divided.

In one camp are those who believe there is no need to complicate a simple issue with social science: people who are obese eat too much food and don’t burn off enough calories. In their view, the way to stop the obesity epidemic — one-quarter of Canadians and 9 per cent of children are obese, according to the federal Public Health Agency — is to compel those who are overweight to exercise some self-discipline.

On the other side are those who believe obesity is a complex eating disorder like anorexia nervosa or bulimia. In their view, it is essential to find out why people use food as a crutch, a weapon or a pain-reliever in order to change their behaviour.

What no one has figured out is how create space between these two extremes for a mature, non-judgmental discussion. Obesity does pose a serious health risk. It is linked to at least a dozen chronic diseases — from type-2 diabetes to colon cancer — costing between $4.6 billion and $7.1 billion. But there has to be a better approach than blaming and shaming those who are already hurting.

Canada hasn’t found it yet. The search is impeded by the rapid growth of the problem, the pressure to treat the symptoms and the public cacophony.

The value of studies like Fuller-Thomson’s is that they prompt health officials to rethink their assumptions and make fat jokes a little less funny.

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